Anat Cell Biol.  2020 Jun;53(2):126-131. 10.5115/acb.20.037.

The comprehensive review of the neurovascular supply of the ankle joint: clinical implications

Affiliations
  • 1PhD Degree Program in Anatomy, Department of Anatomy, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
  • 2Department of Anatomy, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
  • 3Department of Orthopedics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
  • 4Excellence in Osteology Research and Training Center (ORTC), Chiang Mai University, Chiang Mai, Thailand

Abstract

The rupture of ligament in the lateral part of ankle joint is a common injury and can lead to chronic ankle instability and lead to ankle osteoarthritis. Ankle arthroscopy is considered as a standard option to treat various ankle problems due to the need for only minimal incisions and fewer complications when compared to open surgery. However, there are complications associated with arthroscopic surgery e.g. damage to the anatomical structures around the portal placement areas. The present review provides anatomical knowledge of the superficial and deep neurovascular structures in the ankle region. These structures are important when ankle surgery is performed in order to avoid any intraoperative injury and prevent any complication following surgery.

Keyword

Anatomy; Ankle; Arthroscopy; Nerve; Injury

Reference

1. Balduini FC, Tetzlaff J. 1982; Historical perspectives on injuries of the ligaments of the ankle. Clin Sports Med. 1:3–12.
Article
2. Glasgow M, Jackson A, Jamieson AM. 1980; Instability of the ankle after injury to the lateral ligament. J Bone Joint Surg Br. 62(B):196–200. DOI: 10.1302/0301-620X.62B2.7364836.
Article
3. Gutierrez GM, Kaminski TW, Douex AT. 2009; Neuromuscular control and ankle instability. PM R. 1:359–65. DOI: 10.1016/j.pmrj.2009.01.013. PMID: 19627919.
Article
4. Garrick JG. 1977; The frequency of injury, mechanism of injury, and epidemiology of ankle sprains. Am J Sports Med. 5:241–2. DOI: 10.1177/036354657700500606. PMID: 563179.
Article
5. Watt T, Hariharan AR, Brzezinski DW, Caird MS, Zeller JL. 2014; Branching patterns and localization of the common fibular (peroneal) nerve: an anatomical basis for planning safe surgical approaches. Surg Radiol Anat. 36:821–8. DOI: 10.1007/s00276-013-1242-x. PMID: 24292499.
Article
6. Karlsson J, Lansinger O. 1992; Lateral instability of the ankle joint. Clin Orthop Relat Res. (276):253–61. DOI: 10.1097/00003086-199203000-00035.
Article
7. Chan KW, Ding BC, Mroczek KJ. 2011; Acute and chronic lateral ankle instability in the athlete. Bull NYU Hosp Jt Dis. 69:17–26.
8. Guillo S, Bauer T, Lee JW, Takao M, Kong SW, Stone JW, Mangone PG, Molloy A, Perera A, Pearce CJ, Michels F, Tourné Y, Ghorbani A, Calder J. 2013; Consensus in chronic ankle instability: aetiology, assessment, surgical indications and place for arthroscopy. Orthop Traumatol Surg Res. 99(8 Suppl):S411–9. DOI: 10.1016/j.otsr.2013.10.009. PMID: 24268842.
Article
9. Guillo S, Cordier G, Sonnery-Cottet B, Bauer T. 2014; Anatomical reconstruction of the anterior talofibular and calcaneofibular ligaments with an all-arthroscopic surgical technique. Orthop Traumatol Surg Res. 100(8 Suppl):S413–7. DOI: 10.1016/j.otsr.2014.09.009. PMID: 25454336.
Article
10. Amendola A, Petrik J, Webster-Bogaert S. 1996; Ankle arthroscopy: outcome in 79 consecutive patients. Arthroscopy. 12:565–73. DOI: 10.1016/S0749-8063(96)90196-6. PMID: 8902131.
Article
11. Bonnin M, Bouysset M. 1999; Arthroscopy of the ankle: analysis of results and indications on a series of 75 cases. Foot Ankle Int. 20:744–51. DOI: 10.1177/107110079902001113. PMID: 10582853.
Article
12. Deng DF, Hamilton GA, Lee M, Rush S, Ford LA, Patel S. 2012; Complications associated with foot and ankle arthroscopy. J Foot Ankle Surg. 51:281–4. DOI: 10.1053/j.jfas.2011.11.011. PMID: 22188904.
Article
13. Ferkel RD, Small HN, Gittins JE. 2001; Complications in foot and ankle arthroscopy. Clin Orthop Relat Res. (391):89–104. DOI: 10.1097/00003086-200110000-00010. PMID: 11603693.
Article
14. Reebye O. 2004; Anatomical and clinical study of the common fibular nerve. Part 1: anatomical study. Surg Radiol Anat. 26:365–70. DOI: 10.1007/s00276-004-0238-y. PMID: 15300410.
Article
15. Lawrence SJ, Botte MJ. 1995; The deep peroneal nerve in the foot and ankle: an anatomic study. Foot Ankle Int. 16:724–8. DOI: 10.1177/107110079501601110. PMID: 8589813.
Article
16. Moore KL, Dalley AF, Agur AMR. 2014. Clinically oriented anatomy. 7th ed. Wolters Kluwer/Lippincott Williams & Wilkins;Philadelphia:
17. Takao M, Uchio Y, Shu N, Ochi M. 1998; Anatomic bases of ankle arthroscopy: study of superficial and deep peroneal nerves around anterolateral and anterocentral approach. Surg Radiol Anat. 20:317–20. DOI: 10.1007/BF01630612. PMID: 9894310.
Article
18. Barrett SL, Dellon AL, Rosson GD, Walters L. 2006; Superficial peroneal nerve (superficial fibularis nerve): the clinical implications of anatomic variability. J Foot Ankle Surg. 45:174–6. DOI: 10.1053/j.jfas.2006.02.004. PMID: 16651197.
Article
19. Darland AM, Kadakia AR, Zeller JL. 2015; Branching patterns of the superficial peroneal nerve: implications for ankle arthroscopy and for anterolateral surgical approaches to the ankle. J Foot Ankle Surg. 54:332–7. DOI: 10.1053/j.jfas.2014.07.002. PMID: 25262839.
Article
20. Nayak VS, Bhat N, Nayak SS, Sumalatha S. 2019; Anatomical variations in the cutaneous innervation on the dorsum of the foot. Anat Cell Biol. 52:34–7. DOI: 10.5115/acb.2019.52.1.34. PMID: 30984449. PMCID: PMC6449594.
Article
21. Rosson GD, Dellon AL. 2005; Superficial peroneal nerve anatomic variability changes surgical technique. Clin Orthop Relat Res. 438:248–52. DOI: 10.1097/01.blo.0000169041.43495.58. PMID: 16131898.
Article
22. Styf J, Morberg P. 1997; The superficial peroneal tunnel syndrome. Results of treatment by decompression. J Bone Joint Surg Br. 79:801–3. DOI: 10.1302/0301-620X.79B5.0790801. PMID: 9331039.
23. Tzika M, Paraskevas G, Natsis K. 2015; Entrapment of the superficial peroneal nerve: an anatomical insight. J Am Podiatr Med Assoc. 105:150–9. DOI: 10.7547/0003-0538-105.2.150. PMID: 25815655.
24. Johnston EC, Howell SJ. 1999; Tension neuropathy of the superficial peroneal nerve: associated conditions and results of release. Foot Ankle Int. 20:576–82. DOI: 10.1177/107110079902000907. PMID: 10509685.
Article
25. Tonogai I, Hayashi F, Tsuruo Y, Sairyo K. 2019; Examination of the origin and branching direction of the anterior medial malleolar artery from the anterior tibial artery: a cadaveric study. Foot Ankle Spec. 12:167–71. DOI: 10.1177/1938640018768046. PMID: 29631442.
Article
26. Yu JL, Ho E, Wines AP. 2013; Pseudoaneurysms around the foot and ankle: case report and literature review. Foot Ankle Surg. 19:194–8. DOI: 10.1016/j.fas.2012.08.003. PMID: 23830169.
Article
27. Parikh S, Dawe E, Lee C, Whitehead-Clarke T, Smith C, Bendall S. 2017; A cadaveric study showing the anatomical variations in the branches of the dorsalis pedis artery at the level of the ankle joint and its clinical implication in ankle arthroscopy. Ann R Coll Surg Engl. 99:286–8. DOI: 10.1308/rcsann.2016.0288. PMID: 27659360. PMCID: PMC5449669.
Article
28. Kovaleski JE, Hollis J, Heitman RJ, Gurchiek LR, Pearsall AW 4th. 2002; Assessment of ankle-subtalar-joint-complex laxity using an instrumented ankle arthrometer: an experimental cadaveric investigation. J Athl Train. 37:467–74. PMID: 12937569. PMCID: PMC164379.
29. Hubbard TJ, Wikstrom EA. 2010; Ankle sprain: pathophysiology, predisposing factors, and management strategies. Open Access J Sports Med. 1:115–22. DOI: 10.2147/OAJSM.S9060. PMID: 24198549. PMCID: PMC3781861.
30. Brostroem L. 1964; Sprained ankles. I. Anatomic lesions in recent sprains. Acta Chir Scand. 128:483–95. PMID: 14227127.
31. Neuschwander TB, Indresano AA, Hughes TH, Smith BW. 2013; Footprint of the lateral ligament complex of the ankle. Foot Ankle Int. 34:582–6. DOI: 10.1177/1071100712466851. PMID: 23559616.
Article
32. Kovaleski JE, Heitman RJ, Gurchiek LR, Hollis JM, Liu W, Pearsall AW 4th. 2014; Joint stability characteristics of the ankle complex after lateral ligamentous injury, part I: a laboratory comparison using arthrometric measurement. J Athl Train. 49:192–7. DOI: 10.4085/1062-6050-49.2.07. PMID: 24568232. PMCID: PMC3975774.
Article
33. Ajis A, Maffulli N. 2006; Conservative management of chronic ankle instability. Foot Ankle Clin. 11:531–7. DOI: 10.1016/j.fcl.2006.07.004. PMID: 16971246.
Article
34. Giannini S, Ruffilli A, Pagliazzi G, Mazzotti A, Evangelisti G, Buda R, Faldini C. 2014; Treatment algorithm for chronic lateral ankle instability. Muscles Ligaments Tendons J. 4:455–60. DOI: 10.32098/mltj.04.2014.10. PMID: 25767783.
Article
35. Safran MR, Zachazewski JE, Benedetti RS, Bartolozzi AR 3rd, Mandelbaum R. 1999; Lateral ankle sprains: a comprehensive review part 2: treatment and rehabilitation with an emphasis on the athlete. Med Sci Sports Exerc. 31(7 Suppl):S438–47. DOI: 10.1097/00005768-199907001-00005. PMID: 10416545.
Article
36. Karlsson J, Lansinger O. 1993; Chronic lateral instability of the ankle in athletes. Sports Med. 16:355–65. DOI: 10.2165/00007256-199316050-00006. PMID: 8272690.
Article
37. Trevino SG, Davis P, Hecht PJ. 1994; Management of acute and chronic lateral ligament injuries of the ankle. Orthop Clin North Am. 25:1–16.
Article
38. Al-Mohrej OA, Al-Kenani NS. 2016; Chronic ankle instability: current perspectives. Avicenna J Med. 6:103–8. DOI: 10.4103/2231-0770.191446. PMID: 27843798. PMCID: PMC5054646.
Article
39. Becker HP, Rosenbaum D. 1999; [Chronic recurrent ligament instability on the lateral ankle]. Orthopade. 28:483–92. German. DOI: 10.1007/PL00003633.
40. Coughlin MJ, Schenck RC Jr, Grebing BR, Treme G. 2004; Comprehensive reconstruction of the lateral ankle for chronic instability using a free gracilis graft. Foot Ankle Int. 25:231–41. DOI: 10.1177/107110070402500407. PMID: 15132931.
Article
41. Coughlin MJ, Schenck RC Jr. 2001; Lateral ankle reconstruction. 22:256–8. DOI: 10.1177/107110070102200315. PMID: 11310870.
Article
42. Wang B, Xu XY. 2013; Minimally invasive reconstruction of lateral ligaments of the ankle using semitendinosus autograft. Foot Ankle Int. 34:711–5. DOI: 10.1177/1071100713478916. PMID: 23447511.
Article
43. Baumhauer JF, O'Brien T. 2002; Surgical considerations in the treatment of ankle instability. J Athl Train. 37:458–62.
44. Brodsky AR, O'Malley MJ, Bohne WH, Deland JA, Kennedy JG. 2005; An analysis of outcome measures following the Broström-Gould procedure for chronic lateral ankle instability. Foot Ankle Int. 26:816–9. DOI: 10.1177/107110070502601005. PMID: 16221453.
Article
45. Ferkel RD, Chams RN. 2007; Chronic lateral instability: arthroscopic findings and long-term results. Foot Ankle Int. 28:24–31. DOI: 10.3113/FAI.2007.0005. PMID: 17257534.
Article
46. Gould N, Seligson D, Gassman J. 1980; Early and late repair of lateral ligament of the ankle. Foot Ankle. 1:84–9. DOI: 10.1177/107110078000100206. PMID: 7274903.
Article
47. Drakos M, Behrens SB, Mulcahey MK, Paller D, Hoffman E, DiGiovanni CW. 2013; Proximity of arthroscopic ankle stabilization procedures to surrounding structures: an anatomic study. Arthroscopy. 29:1089–94. DOI: 10.1016/j.arthro.2013.02.011. PMID: 23591378.
Article
48. Lintz F, Guillard C, Colin F, Marchand JB, Brilhault J. 2013; Safety and efficiency of a 2-portal lateral approach to arthroscopic subtalar arthrodesis: a cadaveric study. Arthroscopy. 29:1217–23. DOI: 10.1016/j.arthro.2013.04.016. PMID: 23809457.
Article
49. Jorge JT, Gomes TM, Oliva XM. 2018; An anatomical study about the arthroscopic repair of the lateral ligament of the ankle. Foot Ankle Surg. 24:143–8. DOI: 10.1016/j.fas.2017.01.005. PMID: 29409223.
Article
Full Text Links
  • ACB
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr